An Interventional Study to Assess the Efficacy and Safety of Buprenorphine in Korean Patients With Spinal Disorders

A Multicenter, Phase IV, Interventional Study to Assess the Efficacy and Safety of NORSPAN® (Buprenorphine) in Korean Patients With Spinal Disorders (NOBLE)

The purpose of this study is to assess the pain reduction rate after 8 weeks treatment of NORSPAN® from baseline.

And secondary purpose are: pain reduction rate after 4 weeks treatment from baseline(week 0) the EQ-5D, the pain and sleep questionnaire, physician's overall satisfaction subject's overall satisfaction, and safety

Upon providing written informed consent, subject will be screened in the study and assessment will be performed at that time such as safety laboratory assessments, physical examination, vital sign, medical history taking, 24 hours pain intensity score, EQ-5D, pain and sleep questionnaire, physician's overall satisfaction and subject's overall satisfaction.

If patient is eligible in inclusion/exclusion criteria at the time of visit 1, the patient will receive treatment with NORSPAN®.

Treatment with NORSPAN® will be started from 5 μg/h (1 patch a week) for 2 weeks, and proper titration (up-titration) will be allowed at visit 2(wk 2) and at visit 3(wk 4) according to the investigator's decision.

Inclusion Criteria:

• 20 years old or above male or female Korean patients
• Patients who have spinal disorders related pain
• Patients who had been treated with weak opioids and/or NSAIDs before study participation
• Patients who have moderate to severe pain intensity
• Naïve patients for Buprenorphine (Naïve patient are defined as those who had not been treated with Buprenorphine for 90 days)
• Patients who signed a written informed consent form

Exclusion Criteria:

• Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant. UNLESS they are:

  • women whose partners have been sterilized by vasectomy or other means
  • using two birth control methods. The two methods can be a double barrier method or a barrier method plus a hormonal method. Adequate barrier methods of contraception include: diaphragm, condom (by the partner), intrauterine device (copper or hormonal), sponge or spermicide. Hormonal contraceptives include any marketed contraceptive agent that includes an estrogen and/or a progestational agent.

• Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive urine pregnancy test

• Patients with known hypersensitivity to buprenorphine or to any of the excipients

• Patients with severely impaired respiratory function or respiratory depression status

• Patients concurrently receiving MAOIs or who have received MAOIs within the previous two weeks

• Patients with convulsive disorders, head injury, shock, a reduced level of consciousness of uncertain origin, intracranial lesions or increased intracranial pressure, or in patients with severe hepatic impairment

• Patients with biliary tract disorders

• Patients known to have, or suspected of having a history of drug abuse

• Patients with history of opioid or drug dependence

• Patients who are concurrently taking other CNS depressants or muscle relaxants that may cause respiratory depression, hypotension, profound sedation or potentially result in coma.

• Patients who are taking Buprenorphine or strong opioid.

• Any situation where Buprenorphine is contraindicated

• Major surgery within 1 month prior to screening or planned surgery Mainly pain originated other than spinal disorders disease

• Non-malignant patients or cancer patients who are receiving any oncology treatment that could affect the measure of pain control

• With a disability that may prevent the patient from completing all study requirements and in particular, interfere with 24hrs pain intensity score

• Clinically significant impairment of cardiovascular, respiratory and renal function

• Patient who needs acute dose titration or whose pain intensity fluctuate significantly in a short period according to investigator's judgment

• Having used other investigational drugs at the time of enrollment, or within 30 days of enrollment